USVI-On-Line

Really? Who knew? It doesn’t get anything like the publicity that breast cancer will get next month, yet almost 200,000 men will be diagnosed with it this year. For the general population, a man has about a 16 percent chance (1 in 6) of being diagnosed with prostate cancer in his lifetime. Prostate cancer is second among the leading causes of cancer death in men, behind lung cancer.

So, for all the men reading this and for the men in the lives of the women reading this: if you are over 50, please consider getting the PSA test whenever you get blood work done. The PSA (Prostate-Specific Antigen) test is a simple a blood test - just another box to check off on the form when they draw blood to check your cholesterol etc.

Pending additional study, the recommended baseline age for the PSA test may be lowered to 45, and it is prudent to start even younger if there is a history of prostate cancer in the family.

And although PSA levels do tend to rise with age, and prostate cancer is usually very slow growing, pay attention to the rate of rise over time. That’s something they call “velocity” that may indicate a faster growing cancer, and may warrant further investigation and consultation with a urologist who can run additional diagnostic tests. That’s why it is useful to get a baseline in your 40s, so when you start then running the PSA test more often from age 50 and up, you have something to compare it to.

That said, the PSA test has limitations and has been criticized for triggering tests and treatments that also have risks, especially in older men where “watchful waiting” may be a viable option. PSA levels are normally higher in older men than in younger men, even when there is no cancer. A PSA result within the borderline range might be very worrisome in a 50 year old man but cause less concern in a 75 year old man.

The cost/benefit headlines about PSA testing in the media tend to lose sight of the fact that the PSA test is a screening tool, not a diagnostic test. Diagnosis goes beyond mere PSA testing. If you have an elevated level, a urologist can run additional tests before even thinking about biopsy, such as a “percent-free” PSA (fPSA) and another test that looks at the level of something called the prostate cancer gene 3 (PCA3) in the urine. The simple PSA is just a blunt indicator - it is by no means a clear cut diagnostic tool.

As with any medical screening and testing, everybody’s physiology and psychology is different. All you can do is ask better questions when discussing with your doctor.

More information here:

http://www.cancer.org/Cancer/ProstateCa ... -detection

http://www.mayoclinic.com/health/prosta ... er/HQ01273

http://www.cancer.gov/cancertopics/fact ... ection/PSA

One of my husband's classmates (45 yo) discovered he had prostate cancer after a PSA test. His doctor sort of pushed the test on him, he thought it was a waste but gave in, had it done and turns out, he has prostate cancer. It is rather serious and is being treated. He is putting the word out about the value of this test.

Thanks jmq

For me, a regular PSA test and digital exam aren't merely a good idea. I have a pretty high risk of getting prostate cancer so it would be reckless for me to not get tested. Definitely reckless, possibly irresponsible, crazy or suicidal. In addition to the risk factor for any man, both my father and my YOUNGER brother were diagnosed with it. My father's wasn't detected until it had already metastasized to several other parts of the body and it was way too late to treat any of it. My brother's was detected early , was in situ, and he's five years past his surgery and doing fine. Prognosis very good.

My brother-in-law was recently diagnosed and has surgery just a couple of weeks ago. He's not a blood relative, so it doesn't indicate genetic predisposition. But he is younger than me, which gets my attention. And his cancer was also detected early and was also in situ. It was suggested that he could wait a while, but once he knew he had cancer, he wanted it out of him.

So, my brother and brother-in-law, both younger men than me, both had prostate cancer that was detected early and was considered to be very treatable. It could be detected early because they both got regular physicals that they made sure included testing for prostate cancer.

My father, on the other hand, never got physicals. He died ravaged by cancer in several places that had metastasized there from the prostate. No guarantee that had he been having regular physicals the prostate cancer could have been detected and treated and none of the other cancers developed. No guarantee but he certainly would have given himself a lot better chance.

I get checked regularly. Certainly to keep tabs on the prostate, but also to let my doc keep an eye out for all sorts of indicators of all sorts of things. My body certainly put up with a lot of abuse and neglect in my 20s and 30s without showing any signs, but it's clear to me that I have to be pretty serious about my health if I want to continue to have the kind of life I have. I also feel that I have a responsibility to my family.